Welcome to the Silicon Valley Young Professionals (SVYP) Health Corner

Alcohol, The Good, The Bad, The Controversy!

‘Tis the season to be jolly… The month of December epitomizes joy, celebration, and hope.  We look forward to spending time with our friends and family reliving old memories and making new ones.  We also embrace Uncle Jim’s famous rum eggnog while sitting by the wood stove, or my favorite, Glögg (warm, spiced wine).  Finally, many of us start off the New Year with a champagne toast or two. 

There is quite a bit of controversy surrounding alcohol, not only from a cultural and religious perspective but from a medical standpoint as well.   Do you ever wonder why your healthcare provider asks if you drink, and if so how much?  Does knowing how much you drink really matter?   

Yes, it does matter. We ask you these questions because alcohol can impact your health and not always negatively.  However, many treatment decisions are based on whether or not you consume alcohol and if so, how much. 

Okay, so here’s the bad:

We are acutely aware of the risks associated with alcohol intoxication, which can be far worse than that 2 am phone call to your ex. The tragedy associated with injuries and death caused by drunk driving accidents, falls, and acute alcohol poisoning are just a few of the possible consequences of excessive alcohol intake.  Diminished coordination can occur with very small amounts of alcohol which you may not even notice.  Therefore if you are planning to drive or operate dangerous equipment your safest bet is not to drink at all. The University of Rochester provides an interesting summary of the short-term effects of alcohol at different blood alcohol content (BAC) levels.  Check out:  http://www.rochester.edu/uhs/healthtopics/Alcohol/bac.html

Long term health problems associated with drinking include cirrhosis (scarring) of the liver, certain cancers, including certain forms of breast cancer, heart disease, stroke, diabetes, and osteoporosis. The more a person drinks the greater the risk of developing such health problems.  However, breast cancer and osteoporosis risk is increased even with light to moderate consumption (1,2,3,11,12).  Alcohol also packs on the pounds with one gram weighing in at 7 calories. To put that into perspective 1.5 ounces or a shot of vodka is just less than 100 calories .

Now for the good:

The latest research shows that drinking moderate amounts of alcohol is associated with decreased heart disease risk, diabetes and ischemic stroke (a stroke caused by inadequate blood supply).  How is it that the same substance can cause heart disease, stroke and diabetes and decrease an individual’s risk for the same diseases?  The answer lies in the numbers.  Moderate drinking is classified as no more than two drinks per day for men and one drink per day for women (1,2,3,7,8,9,10). The Centers for Disease Control and Prevention (CDC) defines a drink as 12 ounces of beer or wine cooler, 8 ounces of malt liquor, 5 ounces of wine, or 1.5 ounces of 80 proof distilled spirits (4). 

As promising as the research is, it is important to point out that most heart disease benefit was witnessed in middle aged people (>45 years) that already have disease risk (7,8,10).  Additionally, some studies report increased protection from red wine as opposed to other types of alcohol (8).

Now, the burning question…

Why are men able to drink more than women?  The reason is related to the differences in body size and composition. Guys are typically larger in size and have more total-body water.  More importantly, men produce more gastric alcohol dehydrogenase, an enzyme produced by the body that is involved in the breakdown of alcohol (1,4).  Thus, if a male and female both drink the same amount of alcohol, the female will experience a higher degree of intoxication and is at greater risk alcohol related health problems. 

I need to point out that sometimes it’s better not to drink at all because the risk simply outweighs any benefit.  There is no safe level of alcohol intake for pregnant and lactating women, people with liver, pancreatic, or digestive diseases, history of a hemorrhagic stoke (a stroke caused by excessive bleeding), or individuals with a history of alcoholism.  Also certain medications can interact with alcohol (1, 2,3).  Please be advised that this is not a complete list and any questions you might have about drinking alcohol should be directed to your healthcare provider.

Your choice to drink or not is a very personal decision. Consider the circumstance and impact of your decisions, and if you choose to drink, please do so responsibly and in good health. I wish you all a wonderful holiday season.

Next Topic:  Why Chiropractic?

Take Care and Live Well.
Gretchen Suess, MSN, FNP, RN.

1.  Mukamal, K., Fletcher, R. & Sokol, H. (2008). Overview of the risks and benefits of alcohol. Retrieved  December 11, 2008, from http://www.uptodate.com/online/content/topic.do?topicKey=genr_med/4638&selectedTitle=1~150&source=search_result

2.  Tangney, C., Gersh, B., Sokol, N.,  & Rosenson, R. (2008). Cardiovascular benefits and risks of moderate alcohol intake. Retrieved December 11, 2008, from http://www.uptodate.com/online/content/topic.do?topicKey=genr_med/5953&selectedTitle=2~150&source=search_result

3.  Chapter 9, Alcoholic Beverages. Dietary Guidelines for Americans 2005. Retrieved December 18, 2008, from http://www.health.gov/dietaryguidelines/dga2005/document/html/chapter9.htm

4.  Quick Stats General Information on Alcohol Use and Health. Retrieved December 18, 2008, from http://www.cdc.gov/alcohol/quickstats/general_info.htm

5.  Alcohol: Even a Drink a Day Can Adversely Affect Women's Health. Retrieved December 18, 2008, from http://www.mayoclinic.org/news2006-mchi/3271.html

6.  Frezza, M., di Padova, C., Pozzato, G., Terpin, M., Baraona, E., & Lieber, C. (1990). High blood alcohol levels in women. The role of decreased gastric alcohol dehydrogenase activity and first-pass metabolism.. New England Journal of Medicine, 322 (2), 95-99. Retrieved December 18, 2008, from http://content.nejm.org/cgi/content/abstract/322/2/95

7.  Jackson, R. Scragg, R. Beaglehole, R. (1991). Alcohol consumption and risk of coronary heart disease. British Medical Journal, 303 (52), 211-215. Retrieved December 18, 2008, from http://www.pubmedcentral.nih.gov/picrender.fcgi?artid=1670516&blobtype=pdf

8.  Fuchs, CS, Stampfer, MJ, Colditz, GA, Giovannucci, E., Manson, J., Kawachi, I.,  et al.  (1995). Alcohol consumption and mortality among women. New England Journal of Medicine, 332(19), 1245-1250.  Retrieved December 18, 2008, from http://content.nejm.org/cgi/reprint/332/19/1245.pdf

9.  Koppes, L, Dekker, J,  & Hendricks, H, et al. (2005). Moderate alcohol consumption lowers the risk of type 2 diabetes: a meta-analysis of   prospective observational studies. Diabetes Care, 28 (3), 719-725. Retrieved December 18, 2008, from http://care.diabetesjournals.org/cgi/reprint/28/3/719

10. King, D., Arch, G.,  & Geesey, M. (2008). Adopting moderate alcohol consumption in middle age: subsequent cardiovascular events. The   American Journal of Medicine , 121 (3), 201-206. Retrieved December 22, 2008, from http://download.journals.elsevierhealth.com/pdfs/journals/0002-9343/PIIS0002934307011928.pdf

11. Zhang, S., Lee, I., Manson, J., Cook, N., Willett, W, &  Buring, J. (2007). Alcohol Consumption and Breast Cancer Risk in the Women’s Health Study. American Journal of Epidemiology, 165(6), 667-676. Retrieved December 23, 2008, from http://aje.oxfordjournals.org/cgi/reprint/165/6/667

12. Cirrhosis of the Liver. NDDIC; A Service of the (NIDDK), NIH. Retreived December 21, 2008, from http://www.digestive.niddk.nih.gov/ddiseases/pubs/cirrhosis/

13. NIAAA Council Approved Def. of Binge Drinking. Retrieved 21 Dec 08, from http://pubs.niaaa.nih.gov/publications/Newsletter/winter2004/Newsletter_Number3.htm